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BURKINA FASO DEMOGRAPHIC AND HEALTH SURVEY (EDSBF-II) - MEN'S QUESTIONNAIRE 1998


IDENTIFICATION

PROVINCE _____
DEPARTMENT _____
COMMUNE/URBAN CENTER _____
VILLAGE/SECTOR _____
CLUSTER NUMBER _____
NAME OF HEAD OF CONCESSION _____
CONCESSION NUMBER _____
NAME OF HEAD OF HOUSEHOLD _____
HOUSEHOLD UNIT NUMBER _____

URBAN/RURAL:

URBAN 1
RURAL 2

OUAGA/BOBO/OTHER CITIES/RURAL:

OUAGA 1
BOBO 2
OTHER CITIES 3
RURAL 4

INTERVENTION ZONE:

YES 1
NO 2

NAME OF MALE RESPONDENT _____

LINE NUMBER OF MALE RESPONDENT _____


INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE _____
INTERVIEWER'S NAME _____
RESULT _____

1 COMPLETED
2 NOT AT HOME
3 DEFERRED
4 REFUSED
5 PARTIALLY COMPLETED
6 INCAPACITATED
7 OTHER (SPECIFY) _____

NEXT VISIT
DATE _____
TIME _____

FINAL VISIT
DAY _____
MONTH _____
YEAR _____
INT. NUMBER _____
RESULT _____

TOTAL NUMBER OF VISITS _____


LANGUAGE OF INTERVIEW:

FRENCH 1
MOORE 2
DIOULA 3
FULFULDE 4
OTHERS 5

INTERPRETER USED:

YES 1
NO 2

SUPERVISOR
NAME _____
DATE _____

FIELD EDITOR
NAME _____
DATE _____

OFFICE EDITOR _____
KEYED BY _____


SECTION 1: SOCIO-DEMOGRAPHIC CHARACTERISTICS OF THE RESPONDENT

101. RECORD THE TIME:

HOUR _____
MINUTES_____


To begin, I would like to ask you questions about yourself.

103. How long have you been living continuously in (NAME OF CURRENT PLACE OF RESIDENCE)?

YEARS_____

ALWAYS 95
VISITOR 96


105. In what month and year were you born?

MONTH _____
DOESN'T KNOW MONTH 98
YEAR _____
DOESN'T KNOW YEAR 9998


106. How old were you at your last birthday?
COMPARE AND CORRECT 105 AND/OR 106 IF INCONSISTENT.

AGE IN COMPLETED YEARS _______


106A. Do you understand French?

YES 1
NO 2


107. Have you ever attended school?

YES 1
NO 2 (GO TO 111)


108. What is the highest level of school you attended: primary, middle school, high school, or higher?

PRIMARY 1
MIDDLE SCHOOL 2
HIGH SCHOOL 3
HIGHER 4


109. What is the highest grade you completed at that level?

GRADE ______
PRIMARY
0 LESS THAN ONE YEAR COMPLETED
1 1ST GRADE
2 2ND GRADE
3 3RD GRADE
4 4TH GRADE
5 5TH GRADE
8 DOESN'T KNOW
MIDDLE SCHOOL
0 LESS THAN ONE YEAR COMPLETED
1 6TH GRADE
2 7TH GRADE
3 8TH GRADE
4 9TH GRADE
8 DOESN'T KNOW
HIGH SCHOOL
0 LESS THAN ONE YEAR COMPLETED
1 10TH GRADE
2 11TH GRADE
3 12TH GRADE
8 DOESN'T KNOW
POST-SECONDARY
0 LESS THAN ONE YEAR COMPLETED
1 ONE YEAR
2 TWO YEARS
3 THREE YEARS
4 FOUR YEARS
5 FIVE OR MORE YEARS
8 DOESN'T KNOW


110. CHECK 108:

PRIMARY (GO TO 111)
SECONDARY OR HIGHER (GO TO 111A)


111. Can you read and understand a letter or newspaper easily, with difficulty, or not at all?

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3 (GO TO 112A)


111A. Do you read a newspaper or magazine at least once a month?

YES 1
NO 2 (GO TO 112A)


112. Do you read a newspaper or magazine at least once a week?

YES 1
NO 2


112A. Do you listen to the radio?

YES 1
NO 2 (GO TO 113G)


113. Do you listen to the radio every day?

YES 1 (GO TO 113B)
NO 2


113A. On what days of the week do you listen to the radio?
RECORD ALL GIVEN RESPONSES. IF THE RESPONSE IS: "IT DEPENDS", "WHENEVER" OR "DOESN'T KNOW", YOU SHOULD ONLY CIRCLE ONE CODE.

MONDAY A
TUESDAY B
WEDNESDAY C
THURSDAY D
FRIDAY E
SATURDAY F
SUNDAY G
IT DEPENDS/WHENEVER X
DOESN'T KNOW Z


113B. At what times do you usually listen to the radio?
RECORD ALL GIVEN RESPONSES. IF THE RESPONSE IS: "ALL DAY", "IT DEPENDS", "WHENEVER" OR "DOESN'T KNOW", YOU SHOULD ONLY CIRCLE ONE CODE.

BEFORE 8:00 AM A
FROM 8 TO NOON B
FROM NOON TO 2:00 PM C
FROM 2:00-6:00 PM D
FROM 6:00-8:00 PM E
AFTER 8:00 PM F
ALL DAY G
DEPENDS/WHENEVER X
DOESN'T KNOW Z


113C. What types of radio programs do you usually listen to?
PROBE TO GET THE TYPES OF SHOWS. RECORD ALL TYPES MENTIONED.

MUSICAL VARIETY A
SPORTS B
NEWS D
REPORTING E
HEALTH PROGRAMMING F
OTHER (SPECIFY) ____ X


113CA. What radio stations do you usually listen to?
RECORD ALL RESPONSES.

NATIONAL RADIO (RNB) A
PULSAR B
RADIO MARIA C
ARC-EN-CIEL [RAINBOW] D
HORIZON FM E
SALANKOLOTO F
ENERGIE G
RADIO EVANGILE DEVELOPPEMENT H
LUMIERE VIE ET DEVELOPPEMENT I
FOREIGN STATIONS J


113D. Have you ever had the chance to hear the radio program "Yamba Songo"?

YES 1
NO 2 (GO TO 113G)
DOESN'T KNOW THE SHOW (GO TO 113G)


113E. According to you is this series educational in nature or is it just entertainment?

EDUCATIONAL 1
ENTERTAINMENT 2 (GO TO 113G)
BOTH 3
DOESN'T KNOW 8 (GO TO 113G)


113F. In your opinion, which problems does "Yamba Songo" discuss?
RECORD ALL RESPONSES. IF THE RESPONSE IS "DOESN'T KNOW", YOU SHOULD ONLY CIRCLE THAT CODE.

FAMILY PLANNING/CONTRACEPTION A
HIV/AIDS B
SEXUALLY TRANSMITTED DISEASES C
ORS/TREATMENT OF DIARRHEA D
HEALTH PROBLEMS E
OTHER (SPECIFY) _____ X
DOESN'T KNOW Z


113G. Do you watch the television?

YES 1
NO 2 (GO TO 115)


114. Do you watch the television at least once a week?

YES 1
NO 2


114A. On what days of the week do you watch the television?
RECORD ALL GIVEN RESPONSES. IF THE RESPONSE IS "IT DEPENDS", "WHENEVER" OR "DOESN'T KNOW", YOU SHOULD ONLY CIRCLE ONE CODE.

MONDAY A
TUESDAY B
WEDNESDAY C
THURSDAY D
FRIDAY E
SATURDAY F
SUNDAY G
EVERYDAY I
IT DEPENDS/WHENEVER X
DOESN'T KNOW Z


114B. At what times do you usually watch the television?
RECORD ALL GIVEN RESPONSES. IF THE RESPONSE IS "ALL DAY", "IT DEPENDS", "WHENEVER" OR "DOESN'T KNOW": YOU SHOULD ONLY CIRCLE ONE CODE.

THE MORNING A
FROM NOON TO 2:00 PM C
FROM 2:00-6:00 PM D
FROM 6:00-8:00 PM E
AFTER 8:00 PM F
ALL DAY G
DEPENDS/WHENEVER X
DOESN'T KNOW Z


114C. What types of television programs do you usually watch?
PROBE TO GET THE TYPES OF SHOWS. RECORD ALL TYPES MENTIONED.

MUSICAL VARIETY A
SPORTS B
FILMS/SERIES C
NEWS D
REPORTING E
HEALTH PROGRAMMING F
OTHER (SPECIFY) ____ X


114D. What television stations do you usually watch?

NATIONAL STATION (TNB) A
FOREIGN STATIONS B


115. Do you currently work?

YES 1 (GO TO 117)
NO 2


116. Have you done work of any kind during the last 12 months?

YES 1
NO 2 (GO TO 125)


117. What is your occupation, that is, what kind of work do you mainly do?

OCCUPATION ______


118. CHECK 117:

WORKS IN AGRICULTURE (GO TO 119)
DOES NOT WORK IN AGRICULTURE (GO TO 120)


119. Do you work mainly on your own land or on family land, or do you work on land that you rent from someone else, or do you work on someone else's land?

OWN LAND 1
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4
NOT APPLICABLE 5


120. Do you do this work for a member of your family, for someone else, or are you self-employed?

FOR FAMILY MEMBER 1
FOR SOMEONE ELSE 2
SELF-EMPLOYED 3


121. Do you usually work throughout the year, or do you work seasonally, or only once in a while?

THROUGHOUT THE YEAR 1
SEASONALLY/PART OF THE YEAR 2
ONCE IN A WHILE 3


125. What is your religion?

CATHOLIC 1
PROTESTANT 2
MUSLIM 3
TRADITIONAL 4
NOT RELIGIOUS 5
OTHER (SPECIFY) _____ 6


125A. What is your nationality?

BURKINABE 01
NIGERIAN 02 (GO TO 201)
TOGOLESE 03 (GO TO 201)
BENINESE 04 (GO TO 201)
MALIAN 05 (GO TO 201)
IVOIRIAN 06 (GO TO 201)
GHANAN 07 (GO TO 201)
OTHER AFRICAN (SPECIFY) _____ 08 (GO TO 201)
OTHER (SPECIFY) _____ 09 (GO TO 201)


125B. What is your ethnicity?
WRITE DECLARED ETHNICITY, THEN CIRCLE CORRESPONDING CODE.

DECLARED ETHNICITY: _____
BOBO 01
DIOULA 02
FULFULDE/PEUL 03
GOURMATCHE 04
GOUROUNSI 05
LOBI 06
MOSSI 07
SENOUFO 08
TOUAREG/BELLA 09
OTHER (SPECIFY) _____ 10
DOESN'T KNOW 98


SECTION 2: REPRODUCTION

Now I would like to ask you about your children. I am only interested in the children of whom you are the biological father.

201. Have you had any children?

YES 1
NO 2 (GO TO 206)


202. Do you have any sons or daughters who are now living with you?

YES 1
NO 2 (GO TO 204)


203. How many of your sons live with you?
How many of your daughters live with you?
IF NONE, RECORD '00'.

SONS AT HOME _____
DAUGHTERS AT HOME _____


204. Do you have any sons or daughters of whom you are the father and are alive but do not live with you?

YES 1
NO 2 (GO TO 206)


205. How many of your sons are alive but do not live with you?
How many of your daughters are alive but do not live with you?
IF NONE, RECORD '00'.

SONS ELSEWHERE _____
DAUGHTERS ELSEWHERE _____


206. Have you ever had a son or daughter who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life at birth but did not survive more than several hours or days?

YES 1
NO 2 (GO TO 208)


207. How many sons have died?
And how many daughters have died?
IF NONE, RECORD '00'.

SONS DECEASED _____
DAUGHTERS DECEASED _____


208. SUM ANSWERS TO 203, 205, AND 207, AND ENTER TOTAL.
IF NONE, RECORD '00'.

TOTAL ______


209. CHECK 208:
Just to make sure that I have this right: you have had in TOTAL _____ children during your life. Is that correct?

YES (GO TO 210)
NO (PROBE AND CORRECT 201-208 AS NECESSARY)


210. CHECK 208:

HAS HAD CHILDREN (GO TO 210A)
HAS NOT HAD CHILDREN (GO TO 300)


210A. In what month and year was your last child born?

MONTH ____
YEAR ____


210B. CHECK 210A, LAST CHILD:

BORN SINCE JANUARY 1993 (GO TO 211)
BEFORE JANUARY 1993 (GO TO 300)


211. At the time you were expecting your last child, did you want that child at that precise time, did you want to wait longer, or did you not want another child at all?

THAT TIME 1
LATER 2
NOT AT ALL 3


SECTION 3: CONTRACEPTION

Now I would like to talk about family planning -- the various ways or methods that a couple can use to delay or avoid a pregnancy.

CIRCLE CODE '1' IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN COLUMN 302, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE '2' IF METHOD IS RECOGNIZED AND CODE '3' IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE '1' OR '2' CIRCLED IN 301 OR 302, ASK 303.


301. What are the ways or methods you have heard about?
302. Have you ever heard of (METHOD)?

01. PILL: Women can take a pill every day to avoid becoming pregnant.
YES SPONTANEOUSLY 1
YES PROMPTED 2
NO 3 (GO TO NEXT METHOD)
02. IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES SPONTANEOUSLY 1
YES PROMPTED 2
NO 3 (GO TO NEXT METHOD)
03. INJECTABLES: Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.
YES SPONTANEOUSLY 1
YES PROMPTED 2
NO 3 (GO TO NEXT METHOD)
04. MOUSSE, FOAM OR GEL: Women can place a mousse, gel or foam inside their vagina before sexual intercourse.
YES SPONTANEOUSLY 1
YES PROMPTED 2
NO 3 (GO TO NEXT METHOD)
05. CONDOM: Men can put a rubber or latex sheath on their penis before sexual intercourse.
YES SPONTANEOUSLY 1
YES PROMPTED 2
NO 3 (GO TO NEXT METHOD)
06. FEMALE STERILIZATION: Women can have an operation to avoid having any more children.
YES SPONTANEOUSLY 1
YES PROMPTED 2
NO 3 (GO TO NEXT METHOD)
07. MALE STERILIZATION: Men can have an operation to avoid having any more children.
YES SPONTANEOUSLY 1
YES PROMPTED 2
NO 3 (GO TO NEXT METHOD)
08. RHYTHM METHOD: Couples can avoid pregnancy by not having sexual intercourse on the days of the month the woman is most likely to get pregnant.
YES SPONTANEOUSLY 1
YES PROMPTED 2
NO 3 (GO TO NEXT METHOD)
09. WITHDRAWAL: Men can be careful and pull out before ejaculation.
YES SPONTANEOUSLY 1
YES PROMPTED 2
NO 3 (GO TO NEXT METHOD)
10. OTHER METHODS: Have you heard of any other ways or methods that women or men can use to avoid pregnancy? IF YES, LIST UP TO TWO OTHER METHODS.
(SPECIFY) _____
YES 1
NO 3 (GO TO 304)


303. Have you ever used (METHOD)?
THIS QUESTION IS ASKED ABOUT EACH METHOD IN 301 OR 302 WITH '1' OR '2' CIRCLED.

01. PILL: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
02. IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
03. INJECTABLES: Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.
YES 1
NO 2
04. MOUSSE, FOAM OR GEL: Women can place a mousse, gel or foam inside their vagina before sexual intercourse.
YES 1
NO 2
05. CONDOM: Men can put a rubber or latex sheath on their penis before sexual intercourse.
YES 1
NO 2
06. FEMALE STERILIZATION: Women can have an operation to avoid having any more children. Has your partner had an operation to avoid having any more children?
YES 1
NO 2
07. MALE STERILIZATION: Men can have an operation to avoid having any more children. Have you had an operation to avoid having any more children?
YES 1
NO 2
08. RHYTHM METHOD: Couples can avoid pregnancy by not having sexual intercourse on the days of the month the woman is most likely to get pregnant.
YES 1
NO 2
09. WITHDRAWAL: Men can be careful and pull out before ejaculation.
YES 1
NO 2
10. OTHER METHOD(S) (SPECIFY) _____
YES 1
NO 2


304. CHECK 303:

NOT A SINGLE "YES" (NEVER USED) (GO TO 305)
AT LEAST ONE "YES" (EVER USED) (GO TO 307)


305. Have you or one of your partners ever used anything or tried in any way to delay or avoid getting pregnant?

YES 1
NO 2 (GO TO 309)


306. What have you used or done?
CORRECT 302, 303 AND 304 IF NECESSARY.


307. Are you or your partner currently doing something or using any method to delay or avoid a pregnancy?

YES 1
NO 2 (GO TO 309)


308. Which method are you currently using?

PILL 01
IUD 02
INJECTABLES 03
MOUSSE/FOAM/JELLY 04
CONDOM 05
FEMALE STERILIZATION 06
MALE STERILIZATION 07
RHYTHM METHOD 08
WITHDRAWAL 09
OTHER (SPECIFY) _____ 96


308A. Why do you use the (METHOD IN 308) over another method?

COST/NOT EXPENSIVE/IS FREE 01 (GO TO 401)
AVAILABILITY NOT A PROBLEM 02 (GO TO 401)
WAS PRESCRIBED TO RESPONDENT 03 (GO TO 401)
MORE EFFECTIVE 04 (GO TO 401)
NO SIDE EFFECTS 05 (GO TO 401)
CONVENIENCE 06 (GO TO 401)
ONLY METHOD KNOWN 07 (GO TO 401)
REVERSIBLE METHOD 08 (GO TO 401)
PROTECTS AGAINST AIDS/STDS 09 (GO TO 401)
OTHER (SPECIFY) ______ 96 (GO TO 401)


309. What is the main reason that you are not currently using a method to avoid pregnancy?

NOT MARRIED 11
FERTILITY-RELATED REASONS
NOT HAVING SEX 21
INFREQUENT SEX 22
MENOPAUSAL/HYSTERECTOMY 23
SUB-FECUND/IN FECUND 24
POSTPARTUM/BREASTFEEDING 25
WANTS (OTHER) CHILDREN 26
WOMAN IS PREGNANT 27
OPPOSITION TO USE
RESPONDENT OPPOSED 31
SPOUSE/PARTNER OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
CULTURAL TABOOS 35
LACK OF KNOWLEDGE
KNOWS NO METHOD 41
KNOWS NO SOURCE 42
METHOD-RELATED REASONS
HEALTH CONCERNS 51
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COSTS TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NORMAL PROCESSES 56
USAGE CONCERNS WOMAN 61
OTHER (SPECIFY) ______ 96
DOESN'T KNOW 98


SECTION 4: MARRIAGE

401. Are you currently married or living with a woman?

YES, CURRENTLY MARRIED 1
YES, LIVING WITH A WOMAN 2 (GO TO 402A)
FIRST MARRIAGE NOT CONSUMMATED 3 (GO TO 410F)
NO, NOT IN UNION 4 (GO TO 404)


402. How many wives do you have?
402A. With how many women do you live as if married?

NUMBER OF WOMEN/WIVES ____


403. RECORD THE LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE FOR EACH OF HIS WIVES/PARTNERS. IF A WOMAN IS NOT LISTED IN THE HOUSEHOLD, RECORD '00'. THE NUMBER OF BOXES FILLED IN SHOULD BE THE SAME AS THE NUMBER OF WIVES/SPOUSES.

LINE NO. _____ (GO TO 407)


404. Do you currently have a regular sexual partner, an occasional sexual partner, or no sexual partner at all?

REGULAR SEXUAL PARTNER 1
OCCASIONAL SEXUAL PARTNER 2
NO SEXUAL PARTNER 3


405. Have you ever been married or lived with a woman as if married?

YES, FORMERLY MARRIED 1
YES, LIVED WITH A WOMAN 2
NO 3 (GO TO 410F)


406. What is your marital status now: are you widowed, divorced, or separated?

WIDOWED 1
DIVORCED 2
SEPARATED 3


407. Have you been married or lived with a woman only once or more than once?

ONLY ONCE 1
MORE THAN ONCE 2


408. CHECK 407:

MARRIED/LIVED WITH A WOMAN ONLY ONCE: In what month and year did you start living with your wife/partner?

MARRIED/LIVED WITH A WOMAN MORE THAN ONCE: Now I would like to ask you about when you started living with your first wife/partner. In what month and year was that?

MONTH ____
DOESN'T KNOW MONTH 98
YEAR ____ (GO TO 409A)
DOESN'T KNOW YEAR 9998


409. How old were you when you first started living with her?

AGE IN YEARS ____


409A. CHECK 401:

CURRENTLY MARRIED OR LIVING WITH A WOMAN (GO TO 410)
NOT IN UNION (GO TO 410F)


Now I need to ask you some questions about sexual activity in order to better understand certain problems relating to family planning.

410. How long has it been since the last time you had sexual intercourse with your wife/the woman with whom you live?

IF NEVER HAD SEXUAL RELATIONS, RETURN TO 401, CIRCLE CODE '3' (MARRIAGE NOT CONSUMMATED) AND FOLLOW THE NEW INSTRUCTIONS BEGINNING AT 401.

DAYS AGO 1 _____
WEEKS AGO 2 _____
MONTHS AGO 3 _____
YEARS AGO 4 _____


410A. CHECK 301 AND 302:

YES, HAS HEARD OF CONDOMS: Did you use a condom during your last sexual encounter with your wife/the woman with whom you live?

NO, HAS NEVER HEARD OF CONDOMS: Certain men use a condom, that is, they put a rubber sheath on their penis before having sexual intercourse. Did you use a condom during your last sexual encounter with your wife/the woman with whom you live?

YES 1
NO 2 (GO TO 410B)
DOESN'T KNOW/UNSURE 8 (GO TO 410B)


410AA. During your last sexual encounter, who proposed using the condom?

RESPONDENT HIMSELF 1
PARTNER/WIFE 2
BOTH 3


410B. Have you had sexual intercourse with someone other than your wife/the woman with whom you live in the last 12 months?

YES 1
NO 2 (GO TO 410J)


410C. When was the last time you had sexual intercourse with someone other than your wife/the woman with whom you live?

DAYS AGO 1 ____
WEEKS AGO 2 _____
MONTHS AGO 3 _____


410D. Did you use a condom on this occasion?

YES 1
NO 2 (GO TO 410E)
DOESN'T KNOW/UNSURE 8 (GO TO 410E)


410DA. During this last sexual encounter, who proposed using the condom?

RESPONDENT HIMSELF 1
PARTNER 2
BOTH 3


410E. With how many different people other than your wife/the woman with whom you live have you had sexual intercourse in the last 12 months?

NUMBER OF PARTNERS _____ (GO TO 410J)
DOESN'T KNOW 98 (GO TO 410J)


Now I would like to ask you some questions about your sexual activity in order to gain a better understanding of certain problems related to family planning.

410F. How long has it been since the last time you had sexual intercourse (if you have ever had sexual intercourse)?

NEVER 000 (GO TO 509)

DAYS AGO 1 _____
WEEKS AGO 2 _____
MONTHS AGO 3 _____
YEARS AGO 4 _____


410G. CHECK 301 AND 302:

YES, HAS HEARD OF CONDOMS: Did you use a condom during your last sexual encounter?

NO, HAS NEVER HEARD OF CONDOMS: Certain men use a condom, that is, they put a rubber sheath on their penis before having sexual intercourse. Did you use a condom during your last sexual encounter?

YES 1
NO 2 (GO TO 410H)
DOESN'T KNOW/UNSURE 8 (GO TO 410H)


410GA. During this last sexual encounter, who proposed using the condom?

RESPONDENT HIMSELF 1
PARTNER 2
BOTH 3


410H. CHECK 410F:

LESS THAN 12 MONTHS SINCE LAST SEXUAL ENCOUNTER (GO TO 410I)
12 MONTHS OR MORE SINCE LAST SEXUAL ENCOUNTER (GO TO 410J)


410I. In total, with how many people have you had sexual intercourse in the last 12 months?

NUMBER OF PARTNERS _____
DOESN'T KNOW 98


410J. CHECK 401:

CURRENTLY MARRIED OR LIVING WITH A WOMAN: The last time you had sexual intercourse, was it with your wife/woman with whom you live, a regular partner, an acquaintance, someone you paid or someone else?

NOT CURRENTLY MARRIED OR LIVING WITH A WOMAN: The last time you had sexual intercourse, was it with a regular partner, an acquaintance, someone you paid or someone else?

WIFE/WOMAN WITH WHOM HE LIVES 1
REGULAR PARTNER 2
ACQUAINTANCE 3
SOMEONE PAID FOR SEXUAL RELATIONS 4
SOMEONE ELSE 5


413. Do you know of a place where you can get condoms?

YES 1
NO 2 (GO TO 415)


414. Where is that?
RECORD ALL MENTIONED.

EACH TIME A HOSPITAL, HEALTH CENTER, A CSPS OR A CLINIC IS MENTIONED, PROBE TO DETERMINE THE PROPER TYPE OF SECTOR AND CIRCLE THE APPROPRIATE CODE.

PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER B
CSPS C
SMI D
DISPENSARY/MATERNITY POST E
COMMUNITY PHARMACEUTICAL DEPOT F
OTHER PUBLIC (SPECIFY) _____ G
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR'S OFFICE H
FAMILY PLANNING CLINIC I
PHARMACY J
NURSE'S OFFICE K
OTHER PRIVATE (SPECIFY) _____ L
OTHER PRIVATE SECTOR
STORE/MARKET M
BAR/NIGHTCLUB N
KIOSK O
HOTEL/ROOM FOR RENT P
INFORMAL RETAIL CIRCUIT Q
FRIENDS/RELATIVES R
OTHER (SPECIFY) ______ X
OTHER (SPECIFY) ______ Y


414A. CHECK 410A, 410D, AND 410G:

AT LEAST ONE 'YES' (GO TO 414B)
NO 'YES' (GO TO 415)


414B. Where did you obtain condoms the last time?

IF IT IS A HOSPITAL, HEALTH CENTER, A CSPS OR A CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE PROPER TYPE OF SECTOR AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE _____
PUBLIC/PARA-PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER 12
CSPS 13
SMI 14
DISPENSARY/MATERNITY POST 15
COMMUNITY PHARMACEUTICAL DEPOT 16
OTHER PUBLIC (SPECIFY) ______ 17
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR'S OFFICE 21
FAMILY PLANNING CLINIC 22
PHARMACY 23
NURSE'S OFFICE 24
OTHER PRIVATE (SPECIFY) ______ 27
OTHER SOURCE
STORE/MARKET 31
BAR/NIGHTCLUB 32
KIOSK 33
HOTEL/ROOM FOR RENT 34
INFORMAL RETAIL CIRCUIT 35
FRIENDS/RELATIVES 36
PARTNER HAD CONDOM 41 (GO TO 415)
OTHER (SPECIFY) _____ 96


414C. What is the brand name of the condoms you used the last time?

PRUDENCE 1
PACKAGING IS ALL WHITE 2
OTHER (SPECIFY) _____ 96
DOESN'T KNOW 98


414D. The last time you bought condoms, how many did you buy?
DETERMINE THE NUMBER OF CONDOMS AND RECORD THIS NUMBER.

NUMBER OF CONDOMS ____
DOESN'T KNOW 998


414E. How much did you pay?

COST IN CFA ____

FREE 9996 (GO TO 415)
DOESN'T KNOW 9998


414F. If condoms were offered to you for free, would you accept them?
IF THE RESPONSE IS NO, PROBE TO DETERMINE THE REASON AND CIRCLE THE CORRESPONDING CODE.

YES 1
NO, ALREADY SPOILED 2
NO, QUALITY SUSPICIOUS 3
OTHER (SPECIFY) _____ 4


415. What age were you when you had your first sexual encounter?

AGE ____
FIRST TIME WHILE MARRIED 96


SECTION 5: FERTILITY PREFERENCES

501. CHECK 401:

NOT IN UNION (GO TO 502)
CURRENTLY MARRIED/LIVING WITH A WOMAN (GO TO 503)


502. CHECK 404:

REGULAR SEXUAL PARTNER (GO TO 503)
OCCASIONAL SEXUAL PARTNER (GO TO 503)
NO SEXUAL PARTNER (GO TO 505(A))


503. Is your wife/partner (one of your wives/partners) currently pregnant?

YES 1
NO 2 (GO TO 505(A))
DOESN'T KNOW 8 (GO TO 505(A))


504. When she became pregnant, did you want her to become pregnant at that time, did you want her to become pregnant later, or did you not want her to become pregnant at all?

AT THAT TIME 1 (GO TO 505(B))
LATER 2 (GO TO 505(B))
NOT AT ALL 3 (GO TO 505(B))


505(A). WIFE/PARTNER NOT PREGNANT/DOESN'T KNOW/NO WIFE/PARTNER: Now I have some questions about the future. Would you like to have a/another child, or would you prefer not to have any (more) children?

HAVE (A/ANOTHER) CHILD 1
NO MORE/NONE 2 (GO TO 507)
WIFE/PARTNER CAN'T GET PREGNANT 3 (GO TO 507)
SAYS HE CAN NO LONGER HAVE CHILDREN 4 (GO TO 507)
UNDECIDED/DOESN'T KNOW 8 (GO TO 507)


505(B). WIFE/PARTNER PREGNANT: Now I have some questions about the future. After the child you and your wife/partner are expecting now, would you like to have another child, or would you prefer not to have any more children?

HAVE (A/ANOTHER) CHILD 1
NO MORE/NONE 2 (GO TO 507)
WIFE/PARTNER CAN'T GET PREGNANT 3 (GO TO 507)
SAYS HE CAN NO LONGER HAVE CHILDREN 4 (GO TO 507)
UNDECIDED/DOESN'T KNOW 8 (GO TO 507)


506. CHECK 503:

WIFE/PARTNER NOT PREGNANT/DOESN'T KNOW/NO WIFE/PARTNER: How long would you like to wait from now before the birth of (a/another) child?

WIFE/PARTNER PREGNANT: After the birth of the child you are expecting now, how long would you like to wait before the birth of another child?

MONTHS 1 ____
YEARS 2 ____

SOON/NOW 993
SAYS WIFE CAN'T GET PREGNANT 994
AFTER MARRIAGE 995
OTHER (SPECIFY) ______ 996
DOESN'T KNOW 998


507. CHECK 308:
CURRENTLY USING A CONTRACEPTIVE METHOD?

NOT ASKED (GO TO 508)
NOT CURRENTLY USING (GO TO 508)
CURRENTLY USING (GO TO 512)


508. Do you think you will use a contraceptive method to delay or avoid pregnancy at any time in the next 12 months?

YES 1 (GO TO 510)
NO 2
DOESN'T KNOW 8


509. Do you think you will use a contraceptive method in the future?

YES 1
NO 2 (GO TO 511)
DOESN'T KNOW 8 (GO TO 511)


510. Which method would you prefer to use?

PILL 01 (GO TO 512)
IUD 02 (GO TO 512)
INJECTABLES 03 (GO TO 512)
MOUSSE/FOAM/JELLY 04 (GO TO 512)
CONDOM 05 (GO TO 512)
FEMALE STERILIZATION 06 (GO TO 512)
MALE STERILIZATION 07 (GO TO 512)
RHYTHM METHOD 08 (GO TO 512)
WITHDRAWAL 09 (GO TO 512)
OTHER (SPECIFY) _____ 96 (GO TO 512)
UNSURE 98 (GO TO 512)


511. What is the main reason that you think you will never use a contraceptive method?

NOT MARRIED 11
FERTILITY-RELATED REASONS
INFREQUENT SEX 22
MENOPAUSAL/HYSTERECTOMY 23
SUB-FECUND/IN FECUND 24
WANTS (OTHER) CHILDREN 26
OPPOSITION TO USE
RESPONDENT OPPOSED 31
WIFE/PARTNER OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
CULTURAL TABOOS 35
LACK OF KNOWLEDGE
KNOWS NO METHOD 41
KNOWS NO SOURCE 42
METHOD-RELATED REASONS
HEALTH CONCERNS 51
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COSTS TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NORMAL PROCESSES 56
USAGE CONCERNS WOMEN 61
OTHER (SPECIFY) ______ 96
DOESN'T KNOW 98


512. CHECK 202 AND 204:

HAS LIVING CHILDREN: If you could go back to the time you did not have any children and could choose exactly the number of children to have in your whole life, how many would that be?

NO LIVING CHILDREN: If you could choose exactly the number of children to have in your whole life, how many would that be?

PROBE FOR A NUMERIC RESPONSE.

NUMBER OF CHILDREN _____
OTHER (SPECIFY) ______ 96 (GO TO 514)


513. How many of these children would you like to be boys, how many would you like to be girls and for how many would the sex not matter?

NUMBER OF BOYS ____
OTHER (SPECIFY) _____ 96
NUMBER OF GIRLS ____
OTHER (SPECIFY) _____ 96
NUMBER OF EITHER ____
OTHER (SPECIFY) _____ 96


514. In general, do you approve or disapprove of couples that use a method to avoid becoming pregnant?

APPROVE 1
DISAPPROVE 2
NO OPINION 3


515. In your opinion, is it appropriate or inappropriate to speak of family planning:

a) On the radio?
b) On television?

RADIO
APPROPRIATE 1
INAPPROPRIATE 2
DOESN'T KNOW 8
TELEVISION
APPROPRIATE 1
INAPPROPRIATE 2
DOESN'T KNOW 8


516. Over the last few months, have you heard or read messages about family planning:

On the radio?
On the television?
In a newspaper or magazine?
On a poster?
In brochures?
On a billboard?
At a community meeting/association?
From a health center/by a health agent?
At the mosque, church or temple?
At school/by a teacher?
At the workplace?
By a relative/friend?
By a neighbor?
During a theatrical performance?

RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2
NEWSPAPER OR MAGAZINE
YES 1
NO 2
POSTER
YES 1
NO 2
BROCHURE(S)
YES 1
NO 2
BILLBOARD
YES 1
NO 2
COMMUNITY MEETING
YES 1
NO 2
HEALTH SERVICE/HEALTH AGENT
YES 1
NO 2
MOSQUE/CHURCH/TEMPLE
YES 1
NO 2
SCHOOL/TEACHER
YES 1
NO 2
AT WORK PLACE
YES 1
NO 2
FRIEND/RELATIVE
YES 1
NO 2
NEIGHBOR
YES 1
NO 2
THEATRICAL PERFORMANCE
YES 1
NO 2


516A. What is your principal source of information on family planning?

NONE 01
PUBLIC HEALTH PROFESSIONAL 02
PRIVATE HEALTH PROFESSIONAL 03
COMMUNITY HEALTH PROFESSIONAL 04
FAMILY PLANNING CLINIC 05
WIFE/PARTNER 06
OTHER RELATIVES 07
FRIENDS/ACQUAINTANCES 08
RADIO 09
TELEVISION 10
NEWSPAPER/POSTERS 11
SCHOOL/TEACHER 12
COMMUNITY MEETING 13
PROMACO TEAM 14
THEATER 15
DOLOTIERE (COUNSELOR?) 16
CAMEL DRIVER 17
TRADITIONAL STORYTELLER 18
HOTEL OWNER 19
OTHER (SPECIFY) _____ 96
DOESN'T KNOW 98


516B. If you had to choose, from what source would you like to receive information on family planning? IF MORE THAN ONE SOURCE CITED, ASK WHICH IS THE MOST PREFERRED AND CIRCLE THE CORRESPONDING CODE.

NONE 01
PUBLIC HEALTH PROFESSIONAL 02
PRIVATE HEALTH PROFESSIONAL 03
COMMUNITY HEALTH PROFESSIONAL 04
FAMILY PLANNING CLINIC 05
WIFE/PARTNER 06
OTHER RELATIVES 07
FRIENDS/ACQUAINTANCES 08
RADIO 09
TELEVISION 10
NEWSPAPER/POSTERS 11
SCHOOL/LIBRARY 12
COMMUNITY MEETING 13
PROMACO TEAM 14
THEATER 15
DOLOTIERE (COUNSELOR?) 16
CAMEL DRIVER 17
TRADITIONAL STORYTELLER 18
HOTEL OWNER 19
OTHER (SPECIFY) _____ 96
DOESN'T KNOW 98


518. Over the last 12 months, have you discussed family planning with anyone?

YES 1
NO 2 (GO TO 520)


519. With whom did you discuss it? Anyone else?
RECORD ALL PERSONS MENTIONED.

WIFE/PARTNER A
MOTHER B
FATHER C
SISTER(S) D
BROTHER(S) E
DAUGHTER F
SON G
MOTHER-IN-LAW H
FATHER-IN-LAW I
FRIEND(S)/NEIGHBOR(S) J
OTHER (SPECIFY) ______ X


520. CHECK 401:

YES, CURRENTLY MARRIED (GO TO 521)
YES, LIVING WITH A WOMAN (GO TO 521)
NO, NOT IN UNION (GO TO 601A)


Spouses don't always agree on everything. Now I would like to ask you some questions about your wife's/partner's opinions on family planning.

521. Do you think that your wife/wives/partner(s) approve(s) or disapprove(s) of couples that use a method to avoid a pregnancy?

APPROVE(S) 1
DISAPPROVE(S) 2
CERTAIN APPROVE, OTHERS DISAPPROVE 3
DOESN'T KNOW 8


522. How many times over the last 12 months have you discussed family planning with your wife/wives/partner(s) that you live with?

NEVER 1
ONE OR TWO TIMES 2
MORE OFTEN 3


SECTION 6: AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS

601A. Have you ever heard about infections that can be transmitted through sexual contact?

YES 1
NO 2 (GO TO 601F)


601B. Which ones do you know of?
RECORD ALL MENTIONED.

SYPHILIS A
GONORRHEA B
AIDS C
CONDYLOMA (GENITAL WARTS) D
DISCHARGE E
ULCERS F
LOWER ABDOMINAL PAIN G
OTHER (SPECIFY) _____ W
OTHER (SPECIFY) _____ X
DOESN'T KNOW Z


601C. CHECK 410 AND 410F:

HAS HAD SEXUAL INTERCOURSE (GO TO 601D)
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 601F)


601D. In the last 12 months, have you had one of these infections?

YES 1
NO 2 (GO TO 601F)
DOESN'T KNOW 8 (GO TO 601F)


601E. Which infections did you have?
RECORD ALL MENTIONED.

SYPHILIS A
GONORRHEA B
AIDS C
CONDYLOMA (GENITAL WARTS) D
DISCHARGE E
ULCERS F
LOWER ABDOMINAL PAIN G
OTHER (SPECIFY) _____ W
OTHER (SPECIFY) _____ X
DOESN'T KNOW Z


601F. During the last 12 months, have you had an abnormal discharge from your penis?

YES 1
NO 2
DOESN'T KNOW 8


601G. During the last 12 months, have you had a sore or ulcer near your penis?

YES 1
NO 2
DOESN'T KNOW 8


601H. CHECK 601E, 601F, AND 601G:

HAS HAD AT LEAST ONE INFECTION (GO TO 601I)
HAS NOT HAD AN INFECTION (GO TO 601N)


601I. The last time you had (INFECTION FROM 601E/DISCHARGE/ULCER), did you seek advice or treatment?

YES 1
NO 2 (GO TO 601JA)


601J. Where did you seek advice or treatment?
Any other place/Anywhere else?
RECORD ALL MENTIONED.

PUBLIC/PARA-PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER B
CSPS C
SMI D
DISPENSARY/MATERNITY POST E
COMMUNITY PHARMACEUTICAL DEPOT F
OTHER PUBLIC (SPECIFY) ______ G
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR'S OFFICE H
FAMILY PLANNING CLINIC I
PHARMACY J
NURSE'S OFFICE K
OTHER PRIVATE (SPECIFY) ______ L
OTHER SOURCE
STORE/MARKET M
BAR/NIGHTCLUB N
KIOSK O
HOTEL/ROOM FOR RENT P
INFORMAL RETAIL CIRCUIT Q
FRIENDS/RELATIVES R
OTHER (SPECIFY) ______ X
OTHER (SPECIFY) ______ Y


601JA. CHECK 410 AND 410F:

HAS HAD SEXUAL INTERCOURSE (GO TO 601K)
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 601N)


601K. When you had (INFECTION FROM 601E/DISCHARGE/ULCER), did you inform your sexual partner(s)?

YES 1
NO 2


601L. When you had (INFECTION FROM 601E/DISCHARGE/ULCER), did you do anything to avoid infecting your sexual partner(s)?

YES 1
NO 2 (GO TO 601N)
PARTNER ALREADY INFECTED 3 (GO TO 601N)


601M. What did you do?
RECORD ALL MENTIONED.

AVOIDED SEXUAL INTERCOURSE A
USED CONDOMS B
TOOK MEDICATION C
OTHER (SPECIFY) ______ X


601N. CHECK 601B:

DID NOT MENTION "AIDS" (GO TO 601O)
MENTIONED "AIDS" (GO TO 602)


601O. Have you ever heard of an illness called AIDS?

YES 1
NO 2 (GO TO 611C)


602. From which sources have you heard about AIDS?
INSIST: Any other sources?
RECORD ALL MENTIONED.

PUBLIC HEALTH PROFESSIONAL A
PRIVATE HEALTH PROFESSIONAL B
COMMUNITY HEALTH PROFESSIONAL C
FAMILY PLANNING CLINIC D
WIFE/PARTNER F
OTHER RELATIVES G
FRIENDS/RELATIONS H
RADIO I
TELEVISION J
NEWSPAPER/JOURNALS K
BROCHURES L
MOSQUE/CHURCH/TEMPLE M
SCHOOL/TEACHER N
ASSOCIATION MEETING O
THEATER P
WORK PLACE Q
PROMACO TEAM R
DOLOTIERE (COUNSELOR) S
CAMEL DRIVER T
TRADITIONAL STORYTELLER U
HOTEL/RESTAURANT OWNER V
OTHER (SPECIFY) _____ X


602AA. INTERVIEWER: IF YOU HAVE ONLY CIRCLED ONE CODE IN 602, CIRCLE THE CODE CORRESPONDING TO THE SAME RESPONSE HERE AND CONTINUE TO
602AB.

IF YOU CIRCLED MULTIPLE CODES IN 602, ASK THE FOLLOWING QUESTION AND CIRCLE THE CODE THAT CORRESPONDS TO THE RESPONSE: Amongst the sources you cited, which is the primary source?

PUBLIC HEALTH PROFESSIONAL 02
PRIVATE HEALTH PROFESSIONAL 03
COMMUNITY HEALTH PROFESSIONAL 04
FAMILY PLANNING CLINIC 05
WIFE/PARTNER 06
OTHER RELATIVES 07
FRIENDS/RELATIONS 08
RADIO 09
TELEVISION 10
NEWSPAPER/JOURNALS 11
BROCHURES 12
MOSQUE/CHURCH/TEMPLE 13
SCHOOL/TEACHER 14
ASSOCIATION MEETING 15
THEATER 16
WORK PLACE 17
PROMACO TEAM 18
DOLOTIERE (COUNSELOR?) 19
CAMEL DRIVER 20
TRADITIONAL STORYTELLER 21
HOTEL/RESTAURANT OWNER 22
OTHER (SPECIFY) _____ 96


602A. If you had to choose, from which source would you prefer to receive information on AIDS? IF MULTIPLE SOURCES ARE CITED, ASK WHICH IS THE PREFERRED SOURCE AND CIRCLE THE CORRESPONDING CODE.

ANY OF THEM 01
PUBLIC HEALTH PROFESSIONAL 02
PRIVATE HEALTH PROFESSIONAL 03
COMMUNITY HEALTH PROFESSIONAL 04
FAMILY PLANNING CLINIC 05
WIFE/PARTNER 06
OTHER RELATIVES 07
FRIENDS/RELATIONS 08
RADIO 09
TELEVISION 10
NEWSPAPER/JOURNALS 11
BROCHURES 12
MOSQUE/CHURCH/TEMPLE 13
SCHOOL/TEACHER 14
ASSOCIATION MEETING 15
THEATER 16
WORK PLACE 17
PROMACO TEAM 18
DOLOTIERE (COUNSELOR?) 19
CAMEL DRIVER 20
TRADITIONAL STORYTELLER 21
HOTEL/RESTAURANT OWNER 22
OTHER (SPECIFY) _____ 96


602B. In your opinion, how can someone get AIDS?
INSIST: Any other way?
RECORD ALL MENTIONED.

SEXUAL INTERCOURSE A
SEXUAL INTERCOURSE WITH MULTIPLE PARTNERS B
SEXUAL INTERCOURSE WITH PROSTITUTES C
NOT USING A CONDOM D
HOMOSEXUAL RELATIONS E
BLOOD INFUSIONS F
INJECTIONS G
KISSING H
MOSQUITO BITES I
DIRTY BLADES, SCISSORS, KNIVES, AND OTHER CUTTING IMPLEMENTS K
OTHER (SPECIFY) ______ W
OTHER (SPECIFY) ______ X
DOESN'T KNOW Z


603. Is there something people can do to avoid contracting AIDS or the virus that causes AIDS?

YES 1
NO 2 (GO TO 607)
DOESN'T KNOW 8 (GO TO 607)


604. In your opinion, what can one do?
PROBE: Anything else?
RECORD ALL MENTIONED.

BE FAITHFUL A
ABSTAIN FROM HAVING SEX B
USE CONDOMS C
AVOID MULTIPLE PARTNERS D
AVOID PROSTITUTES E
AVOID HOMOSEXUAL RELATIONS F
AVOID BLOOD TRANSFUSIONS G
AVOID INJECTIONS H
AVOID KISSING I
AVOID MOSQUITO BITES J
AVOID DIRTY BLADES/SCISSORS/KNIVES/OTHER CUTTING INSTRUMENTS K
SEEK PROTECTION FROM TRADITIONAL HEALERS L
OTHER (SPECIFY) _____ W
OTHER (SPECIFY) _____ X
DOESN'T KNOW Z


607. Is it possible for a healthy-looking person to have AIDS?

YES 1
NO 2
DOESN'T KNOW 8


608. Do you think that a person with AIDS almost never dies from it, sometimes dies from it, or almost always dies from it?

ALMOST NEVER 1
SOMETIMES 2
ALMOST ALWAYS 3
DOESN'T KNOW 8


608A. Can AIDS can be cured?

YES 1
NO 2
DOESN'T KNOW 8


608B. Can AIDS be passed from mother to child?

YES 1
NO 2
DOESN'T KNOW 8


608C. Do you personally know anyone who has AIDS or has died of AIDS?

YES 1
NO 2
DOESN'T KNOW 8


608D. In your opinion, what should be done with people sick with AIDS?

SEND THEM TO THE HOSPITAL 1
KEEP THEM AT HOME 2
ISOLATE THEM 3
MORALLY SUPPORT THEM 4
OTHER (SPECIFY) _____ 5
DOESN'T KNOW 8


609. Do you think your risk of getting AIDS is small, moderate, significant, or do you think you run no risk at all in contracting AIDS?

SMALL 1
MODERATE 2 (GO TO 609C)
SIGNIFICANT 3 (GO TO 609C)
NO RISK AT ALL 4
HAS AIDS 5 (GO TO 611A)


609B. Why do you think your risk of getting AIDS is small/Why do you think you run no risk of getting AIDS? Are there other reasons?
RECORD ALL MENTIONED.

IS FAITHFUL A (GO TO 611A)
ABSTAINS FROM SEX B (GO TO 611A)
USES CONDOMS C (GO TO 611A)
ONLY HAS SEX WITH ONE PARTNER D (GO TO 611A)
LIMITS NUMBER OF SEXUAL PARTNERS E (GO TO 611A)
AVOIDS SEX WITH PROSTITUTES F (GO TO 611A)
PARTNER HAS NO OTHER PARTNERS G (GO TO 611A
DOESN'T HAVE HOMOSEXUAL RELATIONS H (GO TO 611A)
AVOIDS BLOOD TRANSFUSIONS I (GO TO 611A)
AVOIDS INJECTIONS J (GO TO 611A)
AVOIDS DIRTY BLADES/SCISSORS/OTHER CUTTING IMPLEMENTS K (GO TO 611A)
OTHER (SPECIFY) _____ X (GO TO 611A)


609C. Why do you think your risk of getting AIDS is moderate/Why do you think your risk of getting AIDS is significant? Are there other reasons?
RECORD ALL MENTIONED.

HAS SEX WITH NUMEROUS PROSTITUTES B
DOESN'T USE CONDOMS C
HAS MORE THAN ONE PARTNER D
HAS NUMEROUS PARTNERS E
HAS SEX WITH PROSTITUTE F
PARTNER HAS OTHER PARTNERS G
HOMOSEXUAL RELATIONS H
BLOOD TRANSFUSIONS I
INJECTIONS J
USES DIRTY BLADES, SCISSORS, KNIVES, OTHER CUTTING IMPLEMENTS K
OTHER (SPECIFY) _____ X


611A. Since you've heard about AIDS, have you changed your behavior in order to avoid getting the illness?
IF YES, INSIST: What have you done? Anything else?
RECORD ALL MENTIONED.

HASN'T STARTED HAVING SEX A (GO TO 611C)
STOPPED HAVING SEX B (GO TO 611C)
STARTED TO USE CONDOMS C (GO TO 611C)
LIMITS SEX TO ONE PARTNER D (GO TO 611C)
REDUCED NUMBER OF PARTNERS E (GO TO 611C)
AVOIDS PROSTITUTES F (GO TO 611C)
DEMANDED PARTNER TO BE FAITHFUL G (GO TO 611C)
STOPPED HOMOSEXUAL RELATIONS H (GO TO 611C)
STOPPED INJECTIONS J
AVOIDS DIRTY BLADES/SCISSORS/KNIVES/OTHER CUTTING IMPLEMENTS K
OTHER (SPECIFY) ____ W
OTHER (SPECIFY) ____ X
NO CHANGE Y


611B. Has knowing about AIDS influenced or changed your decision to have sexual relations or your sexual behavior?
IF YES: In what way?
RECORD ALL MENTIONED.

HASN'T STARTED HAVING SEX A
STOPPED HAVING SEX B
STARTED TO USE CONDOMS C
LIMITS SEX TO ONE PARTNER D
REDUCED NUMBER OF PARTNERS E
AVOIDS PROSTITUTES F
STOPPED HOMOSEXUAL RELATIONS H
OTHER (SPECIFY) _____ X
NOT CHANGED SEXUAL BEHAVIOR Y
DOESN'T KNOW Z


611C. Some people use a condom during sexual intercourse to protect themselves from AIDS and other sexually transmitted infections. Have you already heard of this?

YES 1
NO 2 (GO TO 611F)


611D. CHECK 410 AND 410F:

HAS HAD SEXUAL INTERCOURSE (GO TO 611E)
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 613)


611E. We might have already talked about this. Have you ever used a condom during sexual relations to avoid catching or transmitting illnesses such as AIDS?

YES 1
NO 2 (GO TO 611G)


611EA. Do you use a condom from time to time, often, or every time you have sexual relations?

FROM TIME TO TIME 1 (GO TO 611G)
OFTEN 2 (GO TO 611G)
EVERY TIME 3 (GO TO 611G)


611F. CHECK 410 AND 410F:

HAS HAD SEXUAL INTERCOURSE (GO TO 611G)
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 613)


611G. During the last 12 months, have you given or received money, gifts or favors in exchange for sexual intercourse?

YES 1
NO 2


SECTION 7: MEN'S OPINIONS ON THE PRACTICE OF FEMALE CIRCUMCISION

Now I would like to ask you questions about female circumcision, which consists of the total or partial removal of the external parts of a woman's genitalia. This practice exists within certain societies in Burkina and other countries.

701. Have you ever heard of female circumcision?

YES 1
NO 2 (GO TO 706A)


701A. Who makes the decision to circumcise a girl?

MOTHER 1
FATHER 2
BOTH (MOTHER/FATHER) 3
AUNT 4
UNCLE 5
GRANDPARENTS 6
OTHER (SPECIFY) _____ 7


702. Do you think that the practice of female circumcision should continue to be practiced, or on the contrary, that it should not continue to be practiced?

CONTINUED 1
STOPPED 2 (GO TO 705)
DOESN'T KNOW 8 (GO TO 706A)


703. Why do you think that the practice of female circumcision should continue to be practiced? Any other reason? RECORD ALL MENTIONED.

GOOD TRADITION A
CUSTOM AND TRADITION B
RELIGIOUS NECESSITY C (GO TO 706A)
HYGIENE D (GO TO 706A)
BETTER MARRIAGE PROSPECTS E (GO TO 706A)
MORE PLEASURE FOR HUSBAND F (GO TO 706A)
PRESERVE VIRGINITY/AVOID IMMORALITY G (GO TO 706A)
OTHER (SPECIFY) _____ X (GO TO 706A)
DOESN'T KNOW Y (GO TO 706A)


704. What do you mean by "GOOD TRADITION/CUSTOM AND TRADITION"?
RECORD ALL RESPONSES MENTIONED.

CUSTOM AND TRADITION B (GO TO 706A)
RELIGIOUS NECESSITY C (GO TO 706A)
HYGIENE D (GO TO 706A)
BETTER MARRIAGE PROSPECTS E (GO TO 706A)
MORE PLEASURE FOR HUSBAND F (GO TO 706A)
PRESERVE VIRGINITY/AVOID IMMORALITY G (GO TO 706A)
OTHER (SPECIFY) _____ X (GO TO 706A)
DOESN'T KNOW Y (GO TO 706A)


705. Why do you think that the practice of female circumcision should be stopped?
Any other reason? RECORD ALL MENTIONED.

BAD TRADITION A
AGAINST RELIGION B (GO TO 706A)
MEDICAL COMPLICATIONS C (GO TO 706A)
OWN PAINFUL EXPERIENCE D (GO TO 706A)
AGAINST THE DIGNITY OF WOMEN E (GO TO 706A)
IMPEDES SEXUAL SATISFACTION F (GO TO 706A)
LAW EXISTS AGAINST THE PRACTICE G (GO TO 706A)
OTHER (SPECIFY) _____ X (GO TO 706A)
DOESN'T KNOW Y (GO TO 706A)


706. What do you mean by "BAD TRADITION"?
RECORD ALL MENTIONED.

AGAINST RELIGION B
MEDICAL COMPLICATIONS C
OWN PAINFUL EXPERIENCE D
AGAINST THE DIGNITY OF WOMEN E
IMPEDES SEXUAL SATISFACTION F
OTHER (SPECIFY) _____ X
DOESN'T KNOW Y


706A. What is your principal source of information on female circumcision?

NONE 01
PUBLIC HEALTH PROFESSIONAL 02
PRIVATE HEALTH PROFESSIONAL 03
COMMUNITY HEALTH PROFESSIONAL 04
FAMILY PLANNING CLINIC 05
WIFE/PARTNER 06
OTHER RELATIVES 07
FRIENDS/RELATIONS 08
RADIO 09
TELEVISION 10
NEWSPAPER/POSTERS 11
SCHOOL/TEACHER 12
COMMUNITY MEETING 13
PROMACO TEAM 14
THEATER 15
DOLOTIERE (COUNSELOR?) 16
CAMEL DRIVER 17
TRADITIONAL STORYTELLER 18
HOTEL OWNER 19
OTHER (SPECIFY) _____ 96
DOESN'T KNOW 98


706B. If you had to choose, from what source would you prefer to receive information on female circumcision?

ANY OF THEM 01
PUBLIC HEALTH PROFESSIONAL 02
PRIVATE HEALTH PROFESSIONAL 03
COMMUNITY HEALTH PROFESSIONAL 04
FAMILY PLANNING CLINIC 05
WIFE/PARTNER 06
OTHER RELATIVES 07
FRIENDS/RELATIONS 08
RADIO 09
TELEVISION 10
NEWSPAPER/POSTERS 11
SCHOOL/TEACHER 12
COMMUNITY MEETING 13
PROMACO TEAM 14
THEATER 15
DOLOTIERE (COUNSELOR?) 16
CAMEL DRIVER 17
TRADITIONAL STORYTELLER 18
HOTEL OWNER 19
OTHER (SPECIFY) _____ 96
DOESN'T KNOW 98


706C. Do you know that a law exists in Burkina that prohibits female circumcision?

YES 1
NO 2


707. RECORD THE TIME:

HOUR ____
MINUTES ____


INTERVIEWER'S OBSERVATIONS

TO BE FILLED IN AFTER COMPLETING INTERVIEW.

COMMENTS ABOUT RESPONDENT _____

COMMENTS ON SPECIFIC QUESTIONS _____

ANY OTHER COMMENTS _____

SUPERVISOR'S OBSERVATIONS _____
NAME _____
DATE _____

EDITOR'S OBSERVATIONS _____
NAME _____
DATE _____